Bood vitamin levels in children with gastroenteritis. Clinical evaluation and estimation of blood levels of vitamins A, E, C, B1, B2, B6 and of total carotenoids were carried out in 52 consecutive children admitted to the Royal Alexandra Hospital for Children in Sydney during the winter epidemic of diarrhoea.  The children included 37 Europeans and 15 Aboriginals, who were previously apparently healthy.  Of these, 19 Europeans and ten Abororigines were studied also after recovery.  The anthropometric, clinical, microbiological and biochemical data for each child is presented.  Vitamin treatment, duration of symptoms, severity of diarrhoea, stool microbiology and the role of secondary malabsorption as a main cause of the depressed plasma vitamin levels found is discussed.


A family study of coeliac disease.

A family study of coeliac disease. Studies by Thompson, 1 Carter et al, 2 MacDonald et al. and McCrae 4 have all shown a high familial frequency of coeliac disease (CD).  The diagnostic criteria differed in each study; in Thompson's patients the diagnosis was based on clinical or historical data alone; in Carter's study response to a gluten-free diet was required, while in MacDonald's and McCrae's studies the diagnostic criteria included the demonstration of the lesion of CD by small bowel biopsy.  In MacDonald's study some asymptomatic cases were discovered and a few of these had normal fat balance results.  No hereditary pattern emerged from these studies though MacDonald postulated a dominant gene with variable penetrance while McCrae suggested that susceptibility to CD is inhereited multifactorially and that enviromental factors other than dietary gluten are of aetiological importance.  Hoffman et al. 5, on the other hand, have described discordance for CD in identical twins.


Spirometric standards from 387 healthy New Zealand children. Vital capacity and forced expiratory volume in 1 s were measured in 387 healthy European and 16 non-European children aged from five to 11 years.  These measurements were correlated with height, sitting height, arm span, weight, lean weight and age in various combinations.  Suitable linear regression equations are presented from which these lung volumes may be predicted with confidence limits down to approximately +/- 400 ml and +/- 200 ml respectively.


Detection of synovial cysts by transmission-emission scintigrams following intra-articular 169Yb-DTPA. A new simple and safe technique for the detection of synovial cysts is described.  This investigation employs combined transmission-emission scintigraphy following intra-articular injection of 169Yb-DTPA.  Twenty-two joints were investigated in 18 patients.  A high degree of correlation was found between clinical findings and the results of this investigation.  The major advantages of this method are low local radiation to synovial linings, adequate visualisation of periarticular soft tissue, and small volumes required for intra-articular injection.


Leukemias induced by 1-butyl- and 1-propyl-1-nitrosoureas in the rat. The leukemogenic effect of 1-propyl- and 1-butyl-1-nitrosourea (PNU and BNU) was studied in Donryu and Sprague-Dawley rats, which received the chemical in their drinking water. BNU produced leukemia in 42 out of 46 (91%) of the Donryu rats, and the majority of the induced leukemia were myeloblastic type. In the Sprague-Dawley rats, the incidence of leukemia was 70% (47/67), of which 37%(13/35) were myelocytic leukemia, although the development of myeloblastic leukemia was still predominant (54%, 19/35). The leukemogenic activity of PNU was slightly lower than that of BNU; it produced leukemia in 64% (61/95) of the Donryu rats. The predominant type of induced leukemia was myelocytic leukemia (59%, 36/61). Therefore, it was demonstrated through the series of experiments using BNU and PNU that the strength of leukemogenic activity has a close relationship to the types of leukemia induced in animals. Both BNU and PNU, however, provide excellent disease models of myelogeneous leukemia in the human being.


Attempts to transform murine hemopoietic cells by Rauscher leukemia virus. Primary Rauscher leukemia virus (RLV)-induced myeloid leukemias can produce many small clones in agar in the absence of a factor needed for the proliferation of normal myeloid cells. It seems that leukemic cells can more efficiently utilize the small amount of colony-stimulating factor (CSF) that is produced by them. At optimal stimulation by exogenous CSF, leukemic cells exhibit a poorer rate of proliferation than normal bone marrow cells. Hemopoietic cells can replicate the virus after infection in vitro. In some experiments, infection of normal bone marrow cells leads to the production of some cells with the same growth pattern as cells from primary leukemias.


Direct arterial blood pressure measurements in hospitalised patients.


Increased virus budding from Friend erythroleukemic cells treated with dimethyl sulfoxide, dimethyl formamide, and/or bromodeoxyuridine in vitro. Chronically infected Friend leukemia cells (FLC), grown in the presence of dimethyl sulfoxide (DMSO) (2%, v/v), dimethyl formamide (DMF) (1% v/v), or bromodeoxyuridine (BrdU) (3 or 20 mug/ml) for 4 or 7 days, were examined under the electron microscope. It was found that at the 4th day all three compounds induced comparable increases in the number of budding viruses (3 to 5 times that of the control). At the 7th day, the number had remained relatively constant in the BrdU-treated cells in contrast to the cells of the DMSO- or DMF-treated cultures, which showed a further increase of budding viruses. The greatest increase was seen when BrdU was added in combination with either DMSO or DMF, and this was reflected in the apparent increase in the number of extracellular viruses seen in cell pellets. Scanning electron microscopy on whole FLC mounts provided a rapid means of counting budding viruses and a good correlation was obtained between these counts and those made on thin sections by transmission electron microscopy. Attempts to quantitate the number of released viruses in controls and treated cultures after 4 days of growth revealed a 5- to 10-fold increase per cell in the samples treated with a combination of BrdU and either DMSO or DMF. Thymidine failed to prevent the increase of budding viruses induced by BrdU treatment. The number of budding viruses found after treatment with 3 mug/ml BrdU in the presence of 12 mug/ml thymidine was at a level comparable to that found after the individual BrdU treatment Finally, although FLC always contained varying amounts of intracisternal particles, their number, as compared to the paired controls, always decreased after BrdU treatment.


Transformation of cells in human bone tumor cultures. Two cell lines from tumors of 16 patients with osteosarcoma and two cell lines from 5 patients with giant cell tumor of bone showed conversion of cell type after 2 to 13 months in culture. Transformed cells of epithelial like morphology appeared in small focal areas and rapidly overgrew nontransformed cells. These cells were characterized by rapid growth, loss of contact inhibition, and growth in soft agar. Attempts to demonstrate virus(es) by electron microscopy, treatment with chemicals, or by inoculation of human cell lines were thus far unsuccessful. Antigens not present in parental cultures were observed in the transformed cells by fixed immunofluorescence test with sera of 13 and 20 osteosarcoma patients and 3 of 8 patients with giant cell tumor of bone. Absorption of positive sera with transformed cells of either osteosarcoma or giant cell tumor removed the reaction but not with absorption with heterophile material or mycoplasma. Presence of group-specific-like antigen (gs-3) in the transformed cells (but not in parent cultures) was shown by immunofluorescence. Fluids of transformed cultures contained heavy RNA similar to that of oncornaviruses. These findings suggest the presence of viral information in some human bone tumors.


Growth and responsiveness of human granulocytic leukemic cells in vitro. Cells from patients with acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) can be grown and their properties analyzed in agar gel cultures. Levels of the glycoprotein regulator colony stimulating factor (CSF) were found to be elevated in 19-66% of plasmas tested from patients with various types of granulocytic leukemia, and the growth of AML and CML cells in vitro was observed to be dependent on, and responsive to, stimulation by CSF-containing material. In both diseases, the leukemic cells appear to be in a responsive state with respect to normal growth regulators, and potentially alterations in regulator levels may therefore be able to achieve sustained arrest of the growth of leukemic populations.


Proliferation and maturation of human leukemia cells in liquid culture. Bone marrow from patients with acute myelogenous leukemia (AML), acute myelomonocytic leukemia (AMML), chronic myelogenous leukemia (CML), preleukemia, and from healthy volunteers was cultured using a recently developed liquid diffusion technique. Differential and viable cell counts and 3H-thymidine labeling indices were performed at intervals up to 30 days. Differentiation was assessed morphologically by light and electron microscopy, histochemically, and by functional tests for phagocytosis and the presence of surface receptors for IgG. Colony-stimulating activity (CSA) was assayed against normal human bone marrow by the agar colony technique. In acute leukemia cultures, viable cell counts usually fell within the normal range. However, most AML cells failed to demonstrate significant maturation in vitro, and did not produce detectable CSA. In AMML cultures, maturation was defective but some differentiated macrophages were observed and the cells produced high concentrations of CSA. Preleukemic cultures demonstrated normal growth but maturation was impaired as evidenced by a high percentage of immature cells during the first 7 days. CML cultures showed abnormally high growth capacity resulting in viable cell counts 2-3 times normal. In the chronic phase of CML, maturation was qualitatively normal and the cells produced CSA. With the onset of blast transformation, maturation became abnormal but growth remained high. These studies support a concept of AML as a primary defect in cellular maturation and of CML as a primary abnormality of proliferation. The production of CSA by neoplastic cells relates to the degree of monocyte-macrophage differentiation within the leukemic population. Human preleukemia is characterized by a failure of normal maturation in vitro.


Identification and characterization: cell membrane antigens associated with the blast phase of human adult leukemia. Cell membrane antigens which produce delayed skin reactions and are associated with the blast phase of human acute leukemia have been identified and characterized. When patients are in remission, these proteins are not present on their white blood cells. The blast antigens associated with acute lymphatic leukemia (ALL) are also present on early human fetal thymus cells. Blast antigens from acute myelocytic leukemia (AML) appear to have a different structure and are not associated with fetal antigens. The isolation away from blocking factors of purified, solubilized proteins from the leukemic blast cell membranes now permits the possibility of testing to see whether or not such specific antigens will be useful in diagnosis and in immuno-chemotherapy of leukemia.


Cyclocytidine study in the treatment of acute leukemia.


Immunotherapy for acute myelogenous leukemia. One hundred and seven untreated patients with acute myelogenous leukemia (AML) were admitted to St. Bartholomew's Hospital between the 10th October 1970 and the 31st January 1973. Before receiving drugs to induce remission they were allocated alternatively into 2 groups to decide their remission treatment, a group to receive chemotherapy alone and a group to receive the same chemotherapy with immunotherapy. The patients were then given induction chemotherapy and 45 of them attained complete remission. All patients in remission then received chemotherapy consisting of 5 days treatment every 28 days. Patients receiving immunotherapy were also given multiple weekly intradermal injections of irradiated stored AML cells and Glaxo BCG using a Heaf gun. There were 19 patients in the group which received only chemotherapy during remission; 7 of these patients remain alive (median survival after attaining remission--303 days) and only 5 are still in their first remission (median remission length 188 days). Twenty three patients were allocated to receive immunotherapy during remission in addition to chemotherapy and 16 remain alive (median 545 days) and 8 are in their first remission (median 312 days). The difference in survival of the 2 groups is significant with a sigma value of 0.003.


Non-specific esterase zymogram in normal tissue and adenocarcinomas of the human mammary gland.


Editorial: Student admissions.

Editorial: Student admissions.


Letter: Magnifying lens attachment for spectacles.


Letter: Intravascular injection of local anesthetics.


Letter: Caries under composite restorations.


Letter: A dental helath postage stamp?

Letter: A dental helath postage stamp?


Letter: Confusion worse confounded.

Letter: Confusion worse confounded.


Letter: Fluoridation and dental health.

Letter: Fluoridation and dental health.


The selection of dental students. A pilot study of an assessment of potential manula ability by psychometric tests.


Undergraduate training in endodontics. Report of a training method.


The teaching and practice of clinical periodontology in Great Britain. An analysis.


Research projects in the undergraduate dental curriculum.


An elective scheme for dental undergraduates.


The accuracy and efficiency of general anaesthetic machines in dental practice. An investigation.


The use of television in studying postural operative positions.


The General Dental Council.

The General Dental Council.


Postgraduate education.

Postgraduate education.


The practice of dentistry.

The practice of dentistry.


Editorial: Dental Trade Exhibition, 1975.


Letter: Flying dentists.

Letter: Flying dentists.


Letter: Electrosurgical equipment and pacemekers: a possible hazard.


Letter: Perception of malocclusion.

Letter: Perception of malocclusion.


Letter: Bridge prostheses for cleft palate patients.


Oral signs and symptoms in anaemias.

Oral signs and symptoms in anaemias.


Microleakage in fissure sealants as determined by dye penetration and zero resistance current measurement studies.


Letter: The dentist and prevention of infective endocarditis.


Peri-oral injections of local anaesthetic into defined sites.


'T form' lateral incisors. Two case reports.


State abuse of dentistry. A personal view.


Preventive dentistry for school children.


Drug treatments affecting the management of dental patients.


Editorial: To promote high standards.

Editorial: To promote high standards.


Letter: Recommended by the British Dental Association.


Letter: Student admissions.

Letter: Student admissions.


Letter: The plain words.

Letter: The plain words.


Letter: Caries under composite restorations.


Letter: Intravascular injection of local anesthetics.


Letter: Major mental subnormality hospitals and community dental care.


Letter: Take thought for the morrow.

Letter: Take thought for the morrow.


Elastomeric impression materials. A method of measuring dimensional stability.


Semi-permanent restoration of fractured incisors in young patients. A clinical evaluation of one "acid-etch" technique.


The shelf life of activated Nuva Seal.

The shelf life of activated Nuva Seal.


Some etching solutions supplied with adhesive restorative dental materials.


Repair of abraded composite fillings. An in vitro study.


A memorandum by organisations representing the medical and dental professions and by the independent hospitals group (which includes the major provident associations) in reply to "the separation of private practice from N.H.S. hospitals: a consultative document".


Editorial: The consultative document--a threat to freedom.


Letter: Metronidazole: a possible hazard?


Letter: Bridge prostheses for cleft palate patients.


Letter: Fluoridation.

Letter: Fluoridation.


Letter: State abuse of dentistry.

Letter: State abuse of dentistry.


Letter: Control of advertising.

Letter: Control of advertising.


Cementum and other root abnormalities of permanent teeth in cleidocranial dysostosis.


Fluoridation in Cumbria. A clinical study.


Dental pain. An incidence study.

Dental pain. An incidence study.


Notes on a fluoride mouth-rinsing scheme in Portsmouth.


Hospital and community orthodontic services in Leicestershire. A report on co-operation between services.


The prevention of alcoholism: epidemiological studies of the effects of government control measures.


Patterns of use of alcohol, cannabis and tobacco in a student population.


Notes toward the analysis of loss of control in normal and pathological drinkers.


A study into the aetiology of delirium tremens.


The use of an internal standard in the determination of ethanol in blood, brain and vapour.


Aversive conditioning and cognitive mediators with alcoholic respondents.


Reasons for the increase in Irish admission rates for alcoholic disorders.


An investigation of an alcoholism rehabilitation halfway house. IV. Attractions of the halfway house for residents.


Alcoholics' perceptions of selected counseling techniques.


Marijuana and heroin: a study of initiation of drug use by heroin addicts.


A study of methadone maintenance patients with the Minnesota Multiphasic Personality Inventory.


An investigation of personality and caffeine use.


The critical assessment of the T.V. film "The Drug Takers".


The experimental approach to alcoholism.


The hidden alcoholic in general practice.


Special problems in female alcoholism.

Special problems in female alcoholism.


Today's enjoyment--tomorrow's dependency. The road towards the "rock-bottom" and the way back.


Present and future trends in alcohol research.


Rehabilitation of the alcoholic in Sweden.


The contribution of a hospital clinic to the prevention and treatment of alcoholic problems in Glasgow.


Outpatient treatment of acute withdrawal states.


Treatment of delirium tremens.

Treatment of delirium tremens.


Inhibition of normal human in vitro colony forming cells by cells from leukaemic patients. Co-culture in agar of normal bone marrow cells from different individuals gave granulocyte macrophage colony counts that were expected from counts made when the marrows were cultured separately. Co-culture of normal marrow with normal peripheral blood leucocytes (which did not themselves give rise to colonies) caused inhibition of colony growth only when the ratio of peripheral blood to bone marrow cells was of the order of 4 : 1. Peripheral blood or bone marrow cells from 7 of 9 patients with acute myelomonocytic leukaemia, which did not give rise to colonies, caused a marked reduction in the number of colonies obtained from normal marrow cells when cultured with them. This inhibitory effect of leukaemic cells was found when ratios of leukaemic to normal cells were as low as 1 : 4. Additional evidence that the inhibition of normal colony formation was related to the leukaemic process was obtained from follow-up studies on one of the patients whose cells lost the capacity to inhibit normal colony formation during remission and became inhibitory again on relapse.


Agglutination of peripheral blood lymphocytes from cancer patients and not from healthy controls, with the F2A1 histone fraction. A simple, rapid histone agglutination test (HAT) is described. It consists of incubation in microplates or in microtubes of blood lymphocytes isolated from cancer patients and patients with non-malignant diseases with microquantities of histone fraction F2A1. Positive reaction is shown by massive agglutination of lymphocytes of the patients tested (126 subjects): this test was positive in 76% of cases. All controls (59 subjects) were negative.


The metastatic patterns of osteosarcoma. The paper presents a detailed comparison of the anatomical distribution and frequency of clinically evident metastases in 152 cases of osteosarcoma, and autopsy findings in 43 cases. The behaviour of long bone tumours is contrasted with those arising elsewhere, which tend to metastasize less widely because of early death from effects of the primary tumour. In both clinical and autopsy series long bone tumours produced lung metastases (LM) in over 90% of patients dying with metastases, but the terminal frequency of extra-pulmonary metastases (EPM) rises from a clinical level of 33% to 83% at autopsy. There was little difference between tumours of the major long bones in the frequency of either LM or EPM, but EPM from the humerus tended to be fewer and sited above the diaphragm and from the femur below it. EPM most often involved other bones, notably vertebrae and pelvis. Not more than 10% of tumours invaded regional lymph nodes but terminally a quarter of the long bone tumours had metastasized to heart and abdomen. The infrequency of metastases in muscle was confirmed. The median time for LM was 5-6 months after starting treatment, for EPM 9-10. months. First metastases after 24 months were infrequent, especially in children. With delay in the appearance of metastases, whether LM or EPM, post-metastatic survival lengthened. Neither age, sex nor mode of treatment of the primary notably affected metastatic frequency, although recurrences were much more numerous when radiotherapy, even with high dosage, was the definitive treatment. Local recurrence usually appeared within 6-8 months and was shown to lead to increased frequency of osseous metastases. It is suggested that terminal dissemination may often be tertiary but not always from a pulmonary secondary.


Reactivation of scabies rash by methotrexate. A 13-year-old female was on maintenance therapy for acute lymphoblastic leukemia. On three occasions she received methotrexate orally and each time this was associated with reactivation of scabies rash. The mechanisms for this phenomenon are discussed.


Biochemical studies in early infantile autism. In four series of studies on schizophrenic patients and normals we found that all the schizophrenics eliminated N, N-dimethyltryptamines in their urine while none of the normals did so. Similarly, with early infantile autism (Studies I and II) and normal controls, this separation between patiens and normals still held. But ten parents of the five autistic children positive for bufotenin revealed that one or both parents, i.e.,  seven of ten were positive. The Psychiatric Assessment Interview, the Minnesota Multiphasic Personality Index, and the Rorschach indicated no significant evidence of psychopathology. Thus, individuals who revealed no psychopathology could still be positive for bufotenin. In studies III and V, 1 of 13 normals and 13 of 27 normals were positive, respectively. Study IV showed that 6 of 18 autistic children were positive for bufotenin.


Cytogenetic studies in a patient with acute granulocytic leukemia of seven and one-half years duration. During a 7 1/2-yr period we monitored a chromosomally aberrant cell line in a woman with acute granulocytic leukemia (AGL) whose disease followed a rather unusual course. Her initial remission induced with 6-mercaptopurine (6-MP) and prednisone was maintained for 52 mo with biweekly doses of methotrexate (MTX) given orally. Because signs of liver dysfunction occurred, maintenance therapy was stopped. After 15 mo without chemotherapy, she suffered her first relapse (5 yr 7 mo after the initial diagnosis). A second remission, again induced with 6-MP and prednisone, was maintained for 1 yr, after which a second relapse occurred. Another remission lasting for only 4 mo was followed by a relapse of the leukemic process which led to her death. Cytogenetic studies of marrow cells and peripheral blood at the time of her initial diagnosis showed abnormal stem lines with characteristic chromosome markers. A small percentage of malignant cells bearing these markers persisted in her marrow during the years of her prolonged remission. At the time of her first relapse, 75% of her marrow cells had the marker karyotype, and at the time of her death (7 1/2 yr after the leukemia was diagnosed) all analyzable marrow metaphases had the characteristic chromosome changes.


Chromosomes and causation of human cancer and leukemia. XVI. Banding studies of chronic myelocytic leukemia, including five unusual Ph11 translocations. Forty-two Ph1-positive cases of chronic myelocytic leukemia (CML) were examined with chromosomal banding techniques. Thirty-seven of these cases had the "standard" type of Ph1 translocation between chromosomes No. 9 and No. 22 [t(9;22)(q34;q11)] in the Ph1-positive marrow cells; 5 cases had unusual types of Ph1 translocation. Of the 37 cases, 21 had additional numerical and/or structural chromosomal changes, 2 had a missing Y chromosome, and 1 had an extra Ph1 in the Ph1-positive cells. In the 5 cases with unusual types of Ph1 translocation, chromosomes No. 2, No. 9 No. 10, and No. 13 were involved. The clinical picture in these 5 patients did not differ materially from that of the other Ph1-positive patients with CML, probably indicating that the recipient chromosome, with which the translocation from No. 22 takes place, does not play a crucial role in the course of the CML. In the 21 cases with abnormal karyotypes, nonrandom chromosomal changes were observed. Most of the changes were related to events occurring at the centromeric region. The prognosis of cases with only an extra No. 8 or Ph1 appears to be better than that for cases with an iso-17q [I(17a)] chromosome or other extra chromosomes. The presence of the Ph1 (delected No. 22) in every case points to the essentiality of this karyotypic findings in the diagnosis of CML and possibly in the genesis of the disease.


Combination chemotherapy for children with acute lymphocytic leukemia who fail to respond to standard remission-induction therapy. Short courses of cytosine arabinoside (Ara-C), cyclophosphamide, and L-asparaginase were given to seven children with newly diagnosed acute lymphocytic leukemia, who had failed to remit on standard remission induction therapy. These 4-day courses of Ara-C and cyclophophamide followed by 4 days of L-asparaginase were repeated at 3- to 4-week intervals for two or four courses. Complete remission occurred in six patients. The median duration of remission was 94+ days, on various maintenance regimens. The most serious side effect was neutropenia. This combination of these three drugs appears to be effective remission-induction therapy for children with ALL with unfavorable prognostic features.


Fine structure of a radiation-induced osteogenic sarcoma. An osteogenic sarcoma arose in the right orbit of a 7-year-old boy some 5 years after the right orbit had been treated by four courses of radiotherapy (total dose approximately 13,000 rads) for a multicentric retinoblastoma. Death occurred 6 months after the orbital tumor was first detected. Study of the orbital tumor by electron microscopy revealed a cell population of varied morphology in which two main types were identified. In one group, the cells were large with radiolucent cytoplasm, which contained long branching segments of rough endoplasmic reticulum. In the second group, the cells were smaller with irregular nuclei and an electron-dense cytoplasm, which contained short segments of dilated rough endoplasmic reticulum and numerous mitochondria. The first group of cells closely resembled osteoblasts, while the second group had some features of osteoclasts or their percursors. The branching processes of the tumor cells were separated by an amorphous ground substance, which contained collagen-like fibrils and hydroxyapatite crystals. Crystal deposition was in some instances in close relation to extracellular membrane-bound vesicles.


Adriamycin in the treatment of childhood acute leukemia. A Southwest Oncology Group study. Sixty-six children with acute leukemia, in advanced stages of their disease and resistant to conventional chemotherapy, received adriamycin for remssion induction. Seventeen of 46 (37%) evaluable children with acute lymphocytic leukemia achieved a complete remission, and 5 (11%) achieved a partial remission. Two of 12 evaluable children with acute myelogenous leukemia achieved a complete remission, while an additional 3 achieved a partial remission. Two children with erythroleukemia also achieved a complete remission. Previous therapy with daunorubicin did not affect the response rate. The main toxicities observed with adriamycin were myelosuppression, fever, nausea and vomiting, stomatitis, alopecia, and cardiac toxicity (ST segment changes and arrhythmias).


Proliferative fasciitis.

Proliferative fasciitis. The clinical and pathologic features of 53 cases of proliferative fasciitis, a pseudosarcomatous process involving fascia and interlobular fibrous septa of the subcutaneous fat, were reviewed. In the reviewed material, the lesion affected adults exclusively, with a high incidence in patients older than 40 years (median 54 years). It involved most commonly the upper and lower extremities, and microscopically was characterized by a diffuse infiltrative fibroblastic growth intimately associated with multifocal proliferation of large basophilic cells, closely resembling ganglion cells--a microscopic picture akin to proliferative myositis. In 16 of the 53 cases, the lesion had been initially confused with sarcoma because of its rapid growth and its bizarre histologic features. Although the term "proliferative fasciitis" has been used in the past as a symptom for nodular fasciitis, it is suggested that it be limited to the lesion under discussion, in order to emphasize its close relationship to proliferative myositis. Followup information revealed a benign clinical course. Therefore, despite its rapid growth and bizarre microscopic appearance, the lesion is adequately treated by local excision, and there is no indication for radical surgery.


Dental status and treatment needs among institutionalized mentally subnormal persons in Norway. Dental status and treatment needs were studied in a random sample comprising 353 mentally subnormal persons. The sample was drawn to represent institutionalized mentally subnormal persons in Norway aged 5-45. The overall dental health was poor, primarily due to inadequate and fragmentary treatment facilities. Whereas the dental condition of children below 15 years of age was acceptable, as measured by the DMFT index, tooth loss increased rapidly with advancing age. Nearly every second dentulous person needed some conservation, and every tenth needed extraction of one or more teeth. One-third of the patients needed treatment requiring general anesthesia. It was concluded that a new system for the investigation of treatment requirements should be developed. This system must be based on diagnostic and social criteria, and should serve as a guideline for the plannning and delivery of dental services to the various subgroups of mentally subnormal persons.


Effect of mouth rinsing and toothbrushing with fluoride solutions on caries among Norwegian schoolchildren. The caries experience and the plaque and gingival conditions of 14-year-old children participating in fortnightly fluoride (0.2 % NaF) mouth rinsing (88 subjects) were compared with observations in children performing supervised toothbrushing with a fluoride (0.5 % NaF) solution 4-5 times per year (n = 90). Most of the children, 84 and 90% respectively, had participated in these programs for the previous 6 years. Caries was assessed only on radiographs. The mean number of decayed surfaces was 5.8 (s.d. = 4.1, n = 88) and 5.4 (s.d. = 4.1, n = 90). The mean numbers of decayed and filled surfaces were 19.3 +/- 9.2 and 27.9 +/- 10.2 for subjects with rinsing or brushing. This significant difference could not be ascribed to sex, social class, years of residence in the towns, number of dentists performing the previous treatments, toothbrushing habits, use of fluorides at home, or amount of plaque. All children had gingivitis. There were no differences in the mean number of Plaque Index score 2 or the number of Gingival Index score 2 between the children with the different preventive programs. The girls' oral hygiene was better than the boys', but the gingival conditions were the same. Sex, social class, and toothbrushing techniques tended to have a slight influence on the amount of plaque.


A field biopsy method for fluoride determinations in human surface enamel. An enamel biopsy method was developed that is especially intended for use under primitive clinical conditions in field studies. Three successive enamel layers, each of 1 mum or less, were etched off the same delimited area of 3 mm2 by means of perchloric acid, using a microsampler with disposable tips. The biopsy technique was applicable to the vestibular surface of almost all teeth, causing no perceptible damage to the enamel surface. Based on cumulated data from the successive enamel layers, curves were drawn from which F levels at various depths in the outer 3 mum of the enamel could be interpolated. F levels in surface enamel of maxillary first premolars in 40 12-13-year-old children in a locale with 0.5 mg F/l in the drinking water were found to be 3,800, 2,400 and 2,000 parts/10(6) in three successive enamel layers of 0.6, 1.0 and 1.1 mum, respectively, demonstrating a decrease in F concentration of about 1,800 parts/10(6) within this depth interval. Identical F concentrations were found in bilateral premolars.


Some epidemiologic evidence on the etiology of caries. While laboratory research has identified multiple causal factors in dental caries, few epidemiologic studies have been conducted on large representative populations that have utilized enough variables to test the current models of causation. Data from a large, representative study were available to the authors for secondary analysis. The epidemiology of dental caries as presented in the study indicates that the caries patterns in a free-living population were consistent with an infectious and nutrition model of causality. The genetic explanation, while represented in the data, was not as consistent with the findings as the infectious and nutritional explanations.


The influence of examination of the assessment of the intra-examiner error by using the plaque and gingival index systems. The plaque situation on 48 surfaces in 31 children 13 years of age was assessed. A re-examination within 2 hours indicated a significant increase in the number of O Plaque Index scores. Following paired comparison of each of the 48 areas, 22 % of the surfaces were found to have changed score. Significantly more scores indicating improvement of the plaque situation were found at the second examination. A re-examination of plaque on consecutive days in a similar group of children showed no significant changes. Re-examination of the gingival conditions within 2 hours indicated a significant increase in the number of scores of 2 and this was confirmed by the paired comparison on the 48 surfaces. The findings indicate systematic errors rather than intra-examiner inconsistency.


A longitudinal study of dental health in Swedish children aged 3-5 years. This paper presents data concerning caries, gingivitis, interdental spacing, occlusion and oral habits obtained in a longitudinal investigation of 177 children at the ages of 3, 4 and 5 years. It was found that between 3 and 5 years of age, deft increased from 2.01 to 4.05 and defs from 2.69 to 5.98. The occlusal surfaces of the primary second molars and the occlusal and distal surfaces of the primary first molars were the ones most often affected. The mean Gingival Index decreased from 3 to 5 years (P less than 0.05) and also the number of children with a score of 2 from 4 to 5 years (P less than 0.05). The sagittal and transversal relationship between the jaws remained unchanged in most of the children, while the vertical relationship varied with changes in sucking habits. Dummy sucking was initially more than three times as common as finger sucking, but decreased markedly with increasing age. The children with the habit of finger sucking tended to keep this habit. Nocturnal grinding of the teeth was reported by the parents of 13 % of the children. Dental treatment was needed by 61 % at the age of 3, by 71 % at the age of 4 and by 68 % at the age of 5, as they had caries and/or gingivitis with a gingival score of 2. Futhermor, there was a need for orthodontic supervision including treatment. Caries prophylactic treatment was necessary in all age groups.


Dental caries in schoolchildren in some Danish communities with and without school dental service. The purpose of the investigation was to compare the caries prevalence (DMF-T) among 762 7th grade children, of whom one-half had never received school dental care. The children were grouped according to social status in order to see if there was any difference in the caries prevalence between the social groups. The caries prevalence in children both with and without school dental service was high, 9.5 DMF-T and 10.5 DMF-T. The prevalence of untreated caries and secondary caries was lowest in the group with school dental service.


A method for defining the level of periodontal treatment need in a population of 15-year-old schoolchildren. In a public dental service with scarce resources, the presence of gingivitis in teenage children cannot necessarily be considered as indicating treatment need. However, it is suggested that early bone loss may be an important indication for treatment in teenage children and the aim of the present study was to determine whether the presence of early bone loss in 622 15-year-old children assessed by the measurement of loss of attachment could be predicted from more readily identifiable factors such as gingival bleeding or subgingival calculus. However, such screening tests will make errors by including "healthy subjects" or excluding "diseased "subjects. The acceptable balance of these two kinds of error is a public health decision, a decision which may be affected by a number of variables, including the public's and profession's attitudes to the disease, the effectiveness of available treatments and the resources available.


[Objective radiological stereophotogrammetry in dentistry]. By means of objective radiological stereo-photogrammetry of two extraoral stereoscopic radiograms, the location of dislocated impacted teeth was determined preoperatively in a model. During operation it was possible to find the teeth at the computed position.


Additional analyses of the seven city lead study.


Tracer studies of ingestion of dust by urban children. It has been known for many years that the eating of leaded paint is the prime cause of lead poisoning and elevated blood leads of children living in deteriorated housing. Recently, there has been speculation that children may eat dirt and dust contaminated with lead exhausted from cars and that this amount of ingested lead is sufficient to contribute significantly to the childhood lead problem. This study used a naturally occurring radioactive tracer (lead-210) to determine the relative amounts of dust and other lead-containing materials (e.g., paint) eaten by young children. This tracer is present in very low concentrations in paint and in significantly higher concentrations in fallout dust. Stable lead and lead-210 were analyzed in fecal material from 8 children suspected of having elevated body burdens of lead and 10 children living in good housing where lead poisoning is not a problem. The normal children averaged 4 micrograms lead per gram dry feces, with a range of 2 to 7. Of the eight children suspected of having elevated lead body burdens, two had fecal lead values within the normal range. However, the remaining six were 4 to 400 times higher. Despite these differences in fecal lead between the two groups, the groups were essentially identical in the lead-210 content of their feces. The "elevated" children averaged 0.040 picocurie lead-210 per gram dry feces, while the normal group averaged 0.044. The results provide sound evidence that these children suspected of elevated lead body burden were not ingesting dust or air-suspended particulate.


A survey of air and population lead levels in selected American communities. The concentration of lead in the ambient atmosphere was determined at 59 sampling sites in eight American communities during the period 1968-71. Nineteen sampling sites had existed in a similar survey in 1961-62. At 14 of these sites the lead-in-air value was found to be higher in the current study than in 1961-62. The observed annual mean atmospheric concentration of lead varied from 0.14 mug/m3 (Los Alamos) to 4.55 mug/m3 (Downtown Los Angeles). Higher lead values were associated with urbanization. The concentration of lead in the blood of specific well-defined populations was determined. Such populations lived in geographic proximity to specific air sampling sites. In the three metropolitan areas from which both urban and suburban population groups had been obtained, the mean blood lead levels were significantly higher in the former. In two of the three areas the blood lead level was higher in urban smokers and non-smokers than in the corresponding suburban populations, classified by smoking habits. At each location the concentration of lead in the blood of smokers was greater than that in the blood of non-smokers. The magnitude of the observed urban-suburban difference (for populations comparable in smoking habits) ranged from 0.9 mug/100 gms to 4.5 mug/100 gms. It is probable that these observations partially reflect lead absorption from ambient atmospheres differing in lead concentration. There was no significant concordance between the ranking by site of mean air lead levels and that of the mean blood lead levels prevalent in the related populations. The observation that urban levels of blood lead and higher than suburban levels, but that air concentrations of lead are not clearly reflected in blood lead levels on a general national basis, suggests that factors other than the atmospheric lead level are of relatively greater importance in determining the blood lead levels in population groups. No relationship was established between age of participant and the blood lead level. In husband-wife pairs, presumably exposed to similar diets and atmospheres, the males had significantly higher blood lead levels than did the females. This difference could not be attributed to smoking habits or to hematocrit levels. The possibility that the difference was due to dissimilar quantities of foods in the respective diets of men and women was not examined. Studies of dietary lead levels showed them to be generally lower than commonly reported in the literature, 100 mug/day being a closer approximation in the population studies than the widely quoted 300 mug/day.


Clinical studies on men continuously exposed to airborne particulate lead. Two experiments were conducted to determine the effects of low-level exposure to airborne lead particulates on humans. Male volunteers were exposed 23 hours per day for about 18 weeks to either 10.9 mug Pb/m3 or 3.2 mug Pb/m3 of air. The particulate matter consisted primarily of sub-micron sized particles of alpha lead dioxide. During exposure to 10.9 mug Pb/m3, the mean blood-lead level of the men increased to 37 mug/100 ml while the level in controls remained at about 15 mug/100 ml. Exposure to 3.2 mug Pb/m3 elicited an increase in blood-lead to about 27 mug/100 ml. In both cases, the blood-lead levels appeared to plateau after about three months of exposure and subsequent to that, no further increases were observed. About two months after the men left the exposure chamber, their blood-leads returned to near normal levels. Although urinary excretion of lead was always within the limits usually considered normal, there was a definite increase in urinary lead in the men exposed to 10.9 mug Pb/m3 and a somewhat smaller increase in the men exposed to 3.2 mug Pb/m3. The activity of delta-aminolevulinic acid dehydrase was reduced by about 50% in the erythrocytes of men exposed to 10.9 mug Pb/m3, but returned to normal after exposure was terminated. Practically no changes in the activity of the enzyme were noted in the men exposed to 3.2 mug Pb/m3. Exposure to either level of particulate lead did not cause measurable changes in the excretion of heme precursors nor were there any alterations of serum chemistry or hematology profiles in any of the men.


In vitro effect of lead in blood on the determination of delta-aminolevulinic acid dehydrase. Whole blood, as withdrawn, from lead-exposed dogs was added in varying proportions, to whole blood, as withdrawn, from normal (non-exposed) dogs. The resultant red cell ALADP activities and lead concentrations of the mixtures were then determined. It was found that the resultant ALAD activities could be predicted on the basis of simple dilution of the blood with normal ALAD activity by the blood with severely reduced ALAD activity. The observed values for ALAD of the mixtures related to resultant lead concentration according to the equation: Y = a+ bx, rather than to the equation log y = a+ bx as reportedly observed for samples of blood from lead-exposed humans, and from lead-fed dogs. There was no evidence that the ALAD activity contributed by the portion of normal blood in the mixture was affected by the lead contributed by the blood from the lead exposed dog. This is considered as evidence that the reduction in red cell ALAD activity observed in lead-exposed dogs is not an in vitro artifact inherent in the method used to determined ALAD activity...


Two views on restorative dentistry.

Two views on restorative dentistry.


Biologic effects of airborne particulate lead on continuously exposed rats and rhesus monkeys. The biological effects of airborne particulate lead were studied in rats and rhesus monkeys (Macaca mulatta) exposed nearly continuously (22 hours per day) at a concentration of 21.5 mug Pb/cubic meter of air. The year-long exposure elicited an increase in the concentration of lead in the blood to 28 mug/100 ml in the rats and 17 mug/100 ml in the monkeys. Levels of lead in control animals were about 5 mug/100 and 4 mug/100 ml, respectively, in the rats and monkeys. The elevated blood-lead levels reached a maximum during the first few months of exposure and did not increase significantly after that time. Elevated concentrations of lead were also detected in lung, liver, kidney and bone of both species. While concentrations of lead were nearly always less than 1 mug/g in control animals, they rose to 2-3 mug/g in soft tissues of exposed animals and up to 6 mug/g in bone. Differences between lead levels in animals exposed six months or twelve months were very small. The concentration of lead decreased in the soft tissues of animals removed from the chamber after one year's exposure but remained elevated in bone. The activity of the enzyme delta-amino-levulinic acid dehydrase (ALAD) in circulating erythrocytes was inhibited about 70% in rats exposed to the airborne lead. No reduction of the enzyme activity occurred in brain or liver tissue of either the rats or monkeys. Normal levels of ALAD in erythrocytes of the monkeys were too low to permit meaningful measurements. In spite of the reduced ALAD activity in rat erythrocytes, there was no concomitant alteration in the excretion of heme precursors. In all other respects, there appeared to be no deleterious effects on the animals from exposure to the airborne particulate lead. No changes were detected in serum chemistry or hematology nor were there any gross, microscopic or ultrastructural pathologic changes observed.


An epidemiologic approach to community air lead exposure using personal air samplers. Accurate information on the relationship between blood lead and air lead is essential to any consideration of the possible effect of air lead on the body burden. Past studies of occupationally exposed workers have established that such a relationship exists at high levels of air lead exposure. No such information has been available for subjects exposed to the low air lead levels representative of present-day community exposure. Past studies in this area have suffered from inadequate information on actual lead exposure at the air lead levels of concern. Researchers have has to rely on air lead data obtained from stationary samp;ing stations. Because wide variations can exist betwween locations within a city such information could not be assumed to represent the exposure of any individual subject. At lbest they can be considered only approximations of actual exposures. The Naational Research Council recognized the deficiencies of past studies in their report "Airborne lead in perspective" and recommended that "more precise studies are needed of the relation between atmospheric lead in the urban environment and the concentration of lead in the blood, perphaps by the use of personal monitors". This paper describes the study which was undertaken to evaluate the effect of air lead exposure as measured with personal air sampling devices on indices of lead absorption such as blood lead, urine lead, DALA and ALAD activity...


Do the job right the first time.

Do the job right the first time.


Pin-retained amalgams as a restorative approach.


Study of lead concentrations in atmosphere and population in Japan.


Endosseous implants take skill and care.


Your prime mission is good restoration.

Your prime mission is good restoration.


You have responsibility for dentistry's future.


Porcelain crowns can make natural-looking teeth.


He tried it and he likes it.

He tried it and he likes it.


Dentistry for all the people.

Dentistry for all the people.


Milwaukee school reaches out.

Milwaukee school reaches out.


Skits get dental message across.

Skits get dental message across.


Health hucksters bring care to the grass roots.


Do you want to become a teacher?

Do you want to become a teacher?


The Amazon is part of some people's community.


Repent ye sinners--tomorrow brings socialized medicine.


Will an electric current replace the syringe for anesthesia?


Stint at a hospital broadens, deepens.

Stint at a hospital broadens, deepens.


Charge for broken appointments? The judge said 'No".


The costly education of Dr. Danish. 2.

The costly education of Dr. Danish. 2.


Give your patients 'TLC'...and the exact fee.


Your telephone a pet peeve? Try stroking its fur.


Disability..watch your step and watch your policy. 3.


Be a do-it-yourself crime stopper.

Be a do-it-yourself crime stopper.


Bring out the best in people.

Bring out the best in people.


The tax reduction act and what it means to you.


Stop holding back the hands of time.

Stop holding back the hands of time.


Dental nurses? Why not.

Dental nurses? Why not.


So you want to hire your wife.

So you want to hire your wife.


Dr. Danish goes to court. 1.

Dr. Danish goes to court. 1.


Are you a happy personnel manager?

Are you a happy personnel manager?


Dr. Danish and his ideal patient--where did they go wrong? 1.


Games the seductive patient plays.

Games the seductive patient plays.


Harness those insurance forms.

Harness those insurance forms.


How recession-proof is your recall system?


Don't treat your patients--treat your friends.


Put a price tag on your practice.

Put a price tag on your practice.


Present your case without hang-ups. 1.

Present your case without hang-ups. 1.


Dear Mrs. Jones.

Dear Mrs. Jones.


Dr. Lerner's friendly talking machine.

Dr. Lerner's friendly talking machine.


How do you really rate with your staff?

How do you really rate with your staff?


Dr. V's nightmare with the IRS.

Dr. V's nightmare with the IRS.


Explain those X-rays to your patients.

Explain those X-rays to your patients.


Do your patients see the whole picture?

Do your patients see the whole picture?


The case against reciprocity.

The case against reciprocity.


Test case challenges employee benefit ruling.


What's a nice way to say...'you're fired.'.


Embezzlement...one doctor's story.

Embezzlement...one doctor's story.


How much does leasing 'really' cost?

How much does leasing 'really' cost?


Presenting your case--when the patient says 'no'. 3.


Give your service record a brand new look.


IRS rewards employees who blow the whistle.


A better way to schedule patients.

A better way to schedule patients.


The referral fee rip-off.

The referral fee rip-off.


Ready for questions about those X-rays?

Ready for questions about those X-rays?


Better fee presentations spell stronger collections.


Factoring--the selling of accounts receivable.


Your telephone--hotline to higher collections.


Does 'money talk' bother your assistant.


Dr. Danish goes to court. 2.

Dr. Danish goes to court. 2.


Warm handshakes for cold feet.

Warm handshakes for cold feet.


Structural rearrangements associated with the Ph1 chromosome in chronic granulocytic leukaemia. Four cases of C.G.L. in which banding of the Ph1 chromosome was performed were found to have variation from the usual 9/22 translocation pattern. All 4 cases showed a rearrangement involving at least 3 chromosomes, 2 of which were a9 and a22. One of these cases had in addition an XYY karyotype in the bone marrow.


Missing Y chromosome in juvenile chronic myelogenous leukemia. A child with Ph1-negative juvenile chronic myelogenous leukemia (CML) is presented. The only chromosomal abnormality in hematopoietic tissues consisted of an absent Y chromosome. While a missing Y chromosome in adult patients with CML may be associated with a better prognosis, the clinical course in our patient was as malignant as that usually observed in other children with Ph1-negative juvenile CML.


Intermittent chemotherapy and immunotherapy with BCG in remission maintenance of children with acute lymphocytic leukemia: effects upon immunological function. Twelve children with acute lymphocytic leukemia who had been in complete remission on continuous chemotherapy for at least 12 months, were treated with intermittent courses of chemotherapy alternating with BCG inoculation during the drug-free intervals. Measurements were made of leukocyte populations in blood and bone marrow leukemic blastogenic responses of blood lymphoid cells to phytohemmagglutinin and soluble leukemic blast cell membrane antigen. Antibody titers to a soluble leukemic blast-cell membrane-derived antigen were determined. Comparison was made with similar measurements during a second phase of intermittent chemotherapy without BCG inoculation (phase II). Two children showed bone-marrow relapse and two developed central nervous system leukemia during the study. Rises in blood and bone-marrow lymphoid cell numbers were found during both phases of the study. Blastogenic responses to phytohemagglutinin, depressed at the start of the study following at least 12 months of continuous chemotherapy, rose during intermittent chemotherapy and BCG and remained within normal ranges during phase II. Antibody titers and blastogenic responses to leukemia blast-cell membrane antigens increased in eight of twelve and six of seven children respectively during the BCG phase and were maintained during phase II. Only one child showed further increases in phase II. The combination of BCG and intermittent chemotherapy may increase leukemia-associated immunity in some patients with acute lymphocytic leukemia in remission. The separate contributions of either BCG or intermittent chemotherapy in producing this effect cannot be determined by this study.


Distinctive banded marker chromosomes of human tumor cell lines. Nine human tumor cell lines (five breast carcinomas and four sarcomas) have been studied and each revealed groups of distinctive banded marker chromosomes which can serve to identify them and aid in monitoring cell line specificity. This was possible neither by conventional karyology in terms of numbers and morphology of chromosomes nor by glucose-6-phosphate-dehydrogenase mobility which was type B for all cultures. The significance of the clonal nature of the cell lines is discussed.


Improved cavity design for amalgam restorations.


Root canal filling materials. A review of endodontic materials in current use.


Present status in dental materials. Luting cements.


The dental focal infection as an origin for uveitis.


Intraoral technique for treatment of fractures of the zygomatic arch.


A review of the properties of elastomeric impression materials.


Isolation of a 35S-labelled sulphated glycoprotein from the rabbit submandibular gland.


Calcium hydroxide in the treatment of pulpless teeth with associated pathology.


Endodontic spiral root-fillers.

Endodontic spiral root-fillers.


A radiographic study of root filled teeth.


Letter: Public accountability.

Letter: Public accountability.


Letter: Interseptal alveoplasty.

Letter: Interseptal alveoplasty.


Letter: General anesthesia a radical procedure.


ACFD supports concept of consumer involvement in accreditation process.


Where do we go from here?

Where do we go from here?


An in vitro enamel cleaning method for examining teeth by scanning electron microscopy.


How busy are California's dentists?

How busy are California's dentists?


Editorial: CFDE--helpful ideas.

Editorial: CFDE--helpful ideas.


Health Disciplines Act proclaimed law in Ontario.


CFDE--a reflection of the profession's interest in the future.


Scanning and transmission electron microscopic examination of occlusal surface plaque following tooth brushing.


What hat should today's dentist wear? Doctor's, lawyer's or Indian chief's?


Self-application in a phospho-fluoride brushing study.


Effectiveness of self prophylaxis and rubber cup prophylaxis for improving paedodontic home care.


Effect of preparation geometry on retention and resistance of cast gold restorations.


Effect of human lysozyme (muramidase) on potassium handling by the perfused rat kidney. A mechanism for renal damage in human monocytic leukaemia. Purified human lysozyme (muramidase) stimulated potassium excretion by the isolated perfused rat kidney. Lysozyme is filtered and reabsorbed, without a tubular maximum. Over 90% of lysozyme filtered is retained within the kidney; 50% was recovered by enzymic assay and histologically localized to the proximal tubular cells. Hypokalaemia seen in some patients with myelomonocytic leukaemia may be directly attributed to an elevated circulating lysozyme level.


Periodontal treatment of multirooted teeth. Results after 5 years. This paper describes: (1) a system for classification and treatment of furcation involvements, and (2) a 5-year post-operative evaluation of 100 patients treated for periodontal breakdown in the bi/tri-function areas. The results of this study demonstrate that it is possible to arrest further destruction within the root furcation area. The successful treatment of the multirooted teeth was probably the consequence of: (1) the quasi total elimination of plaque retention areas from the bi/tri-furcation area, and (2) meticulous oral hygiene by the patients.


Influence of occlusal adjustment by grinding on gingivitis and mobility of traumatized teeth. The effect on marginal inflammation and tooth mobility of occlusal adjustment by grinding was investigated in 43 occlusally traumatized teeth in 29 subjects with gingivitis and marginal periodontitis. The material consisted of 4 groups with tooth mobility of varying degrees of severity, and bone destruction. In all groups increased tooth mobility decreased subsequent to occlusal adjustment. The latter was without effect on the sulcus fluid flow rate or gingivitis scores in either gingivitis or periodontitis patients.


Effect of chlorhexidine on dental plaque formation under periodontal pack. In a first experiment, no appreciable differences in plaque formation under periodontal packs were observed in subjects rinsing with and without 0.2% chlorhexidine digluconate. In a second experiment, one gram periodontal packs were coated with 15 to 20 mg of chlorhexidine dihydrochloride powder prior to application and allowed to remain in situ for 4 days. Significantly less plaque formed under periodontal packs with chlorhexidine powder than with control packs. Chlorhexidine dihydrochloride powder may be recommended under periodontal packs for reduction of microbial plaque.


Effect of chlorhexidine on gingival wound healing in the dog. A histometric study. Wound healing after gingivectomy was studied in five 1-year-old dogs (Beagles). During a preparatory period of 4 months, the teeth of the dogs were brushed twice a day using a toothbrush and dentifrice. At the end of this period, all gingival units appeared healthy. All mechanical tooth cleaning procedures were then terminated. Following a period a 2 weeks without oral hygiene, six gingival units, taken bilaterally from the maxillary first molar and posterior premolar areas, were subjected to standardized gingivectomies. Subsequently, the biopsied areas of the left half of the jaws were treated twice a day with a 0.2% aqueous solution of chlorhexidine digluconate for 42 days, while corresponding areas of the right jaws were given saline treatment. Tissue specimens were obtained after healing periods of 42, 28, 14, 7, 4 and 2 days. They were then immediately placed in a Karnovsky fixative, and afterwards decalcified in EDTA. The rate of tissue regeneration and degree of inflammatory cell infiltration were evaluated with histometric methods. It was found that while gingival wounds treated with saline regenerated with extensive inflammatory reactions, corresponding chlorhexidine-treated wounds healed with only minor signs of inflammation.


Creep in denture base polymers.

Creep in denture base polymers.


Mandibular infection as a possible aetiological factor in taurodontism.


Congenitally absent maxillary lateral incisors in the adult: a combined orthodontic and restorative approach to treatment.


Supernumerary premolars: a case report.

Supernumerary premolars: a case report.


A small tensometer employing beam-mounted strain gauges.


Dilaceration of both upper central incisor teeth: a case report.


Cervical external root resorption.

Cervical external root resorption.


Letter: Blood pressure check by dentist.


Editorial: Don't go to sleep on the student payback issue.


Letter: The proper approach to dilacerated roots.


Letter: Tongue-thrusting problem.

Letter: Tongue-thrusting problem.


Letter: Lack of quality control in dentistry.


Letter: South Carolina program screens for hypertension.


Letter: Cancer detection, diagnosis.

Letter: Cancer detection, diagnosis.


Letter: Teaching self-examination of the head and neck: another aspect of preventive dentistry.


Letter: Eye injuries in dental office.

Letter: Eye injuries in dental office.


Letter: Psychotherapy for the myofascial pain-dysfunction syndrome: a study of factors coinciding with symptom remission.


Common medical emergencies: a dilemma in dental education. A four-week hospital-based program offers a comprehensive course for dental students in the evaluation and management of medical emergencies. The program first emphasizes medical evaluation with the taking of accurate, comprehensive patient histories and the performance of physical examinations; information about supportive care, including intravenous techniques and airway maintenance, is given. The diagnostic signs and treatment of common medical emergencies, as taught in the program, are described.


Carotid system arteritis: an overlooked and misdiagnosed syndrome. Because of the broadened scope of dental practice, a thorough knowledge and understanding of head and neck pain is necessary to diagnose adequately and to treat the patient properly. The complexities of disease related to head and neck pain may mislead and confuse the diagnostician. Carotid system arteritis may be easily overlooked in everyday practice. Diseases with similar symptoms must be considered before rendering treatment. Although the mortality rate of arteritis is extremely low, the condition merits immediate recognition and treatment for relief of pain. The need to include head and neck arteritis in the differential diagnosis of orofacial-neck pain has been discussed and a treatment regimen with use of corticosteroids has been suggested.


Commission on Licensure: 1975 annual report.


Composition and structure of dental enamel: elemental composition and crystalline structure of dental enamel as they relate to its solubility. The same elements, 21 in number, were found in both acid-resistant and acid-susceptible enamel specimens by ion microprobe analyses. However, there were differences in the concentrations of 14 elements between groups. Of the 16 trace elements found in enamel, the concentrations of K, F, and Na in parts per million were the greatest. Enamel surface analyses showed V and Zn were more concentrated in acid-resistant specimens by factors of 7.4 and 6.1 respectively, followed by nine other elements, the last molybdenum, that were just slightly more prevalent in acid-resistant enamel. Four elements were equally concentrated in both groups of samples, and only one trace element, B, was more abundant in the acid-susceptible samples by a factor of ten. Ca and P were predominantly more abundant in acid-resistant speciems, and C, H, and O were more concentrated in acid-susceptible samples. The enamel substance in acid-resistant and acid-susceptible groups was found to be similar by these methods. --Ion microprobe: the same elements were detected in both groups. Four trace elements (titanium, lead, Cl, and lithium) were equally abundant in the two groups. --Electron diffraction: the crystal structure type was the same in both groups of samples. --Infrared absorption: the crystalline substance showed the same spectra in both groups. The enamel substance in the two groups of specimens was found to be dissimilar by these methods. --Ion microprobe: the concentrations of 11 trace elements as well as Ca and P were greater in acid-resistant enamel. The concentrations of C, H, O, and B were greater in acid-susceptible enamel. --X-ray diffraction: crystallites in the acid-resistant specimens were larger by a factor of more than two. Enamel solubility appears not to be related to atomic species but associated with one, some, or all elements quantitatively and also with its physical form (crystallite size and probably density).


Treatment of temporomandibular joint syndrome with biofeedback training. Treatment of temporomandibular joint syndrome by the use of biofeedback training involves two stages. First, the patient is made aware of the level of tension in the masseter muscle and, second, he is taught to reduce the level of tension. In those individuals whose pain most likely is associated with high muscle tension, this treatment method is apparently successful. The successful treatment of a patient with a history of long-term TMJ pain is described.


Prevalence and localization of Streptococcus mutans in infants and children. The prevalence and localization of Streptococcus mutans in the oral cavities of 92 children was investigated. The ages of the children ranged from newborns to 5 years. The edentulous newborns and infants with only their deciduous incisors did not harbor S mutans on the mucous membranes or the smooth surfaces of the incisors. As the number of erupted deciduous teeth increased, there was a gradual increase in the isolation of the organism. The greatest isolation frequency of S mutans, 46.3%, occurred in those children with a complete deciduous dentition and contact between the deciduous molars. The interproximal areas where there was molar contact were the most frequent sites of early colonization of S mutans.


Acceptance Program for rapid processing devices for dental radiographic film. Council on Dental Materials and Devices.


Status report on silver amalgam. Council on Dental Materials and Devices. This report discusses the current status of amalgam. The new alloy systems have been reviewed in relation to their advantages, disadvantages, and clinical use. Values for the physical properties of amalgam have increased tremendously in the past 50 years and relatively recent changes in alloy composition, size, and shape of particles can produce clinically observable improvements in restorations, particularly with respect to marginal integrity. New alloys that are now available or are very close to being introduced on the market should be investigated and observed by practitioners. However, it should be recognized that correct alloy manipulation of currently available alloys probably has more influence on the longevity of restorations than the type of alloy selected.


Mercury vapor levels in dental offices: a simple semiquantitative test.


Observations on the epidemiology of Rift Valley fever in Kenya. The epizootic range of Rift Valley fever in Kenya is defined from the results of virus isolations during epizootics, and form an extensive serological survey of cattle which were exposed during an epizootic. A study of the sera from a wide range of wild bovidae sampled immediately after the epizootic, showed that they did not act as reservoir or amplifying hosts for RVF. Virus isolation attempts from a variety of rodents proved negative. Rift Valley fever did not persist between epizootics by producing symptomless abortions in cattle in areas within its epizootic range. A sentinel herd sampled annually after an epizootic in 1968 revealed not one single seroconversion from 1969 to 1974. Certain forest and forest edge situations were postulated as enzootic for Rift Valley fever, and a small percentage of seroconversions were detected in cattle in these areas, born four years after the last epizootic. This has been the only evidence for the persistence of the virus in Kenya since 1968, and may be a part of the interepizootic maintenance cycle for Rift Valley fever in Kenya, which otherwise remains unknown.


Continuing education: course listing for September 1975 through February 1976. Bureau of Dental Society Services. Council on Dental Education.


The differential transmissibility of Myxoma virus strains of differing virulence grades by the rabbit flea Spilopsyllus cuniculi (Dale). Laboratory studies showed that few rabbit fleas (Spilopsyllus cuniculi (Dale)) transmitted myxomatosis after removal from wild rabbits (Oryctolagus cuniculus (L) that had been infected for fever than 10-12 days, irrespective of the virulence of the myxoma virus strain involved. Rabbits infected with fully virulent (Grade I) strains died within 10-15 days and few fleas from these hosts became infective; averaging all the samples takem. 12% of the fleas were infective. Also, few fleas acquired infectivity on individual rabbits which covered from infection with attenuated strains; the mean was 8% infective. Rabbits which died between 17 and 44 days after infection had higher proportions of infective fleas at all sampling times; the mean was 42% infective. Male and female fleas transmitted virus with equal efficiency. For rabbits infected with any of the attenuated virus strains the mean percentage of infective fleas was inversely related to the survival time of the host. Rabbits infected with moderately attenuated strains (Grades IIIA and IIIB) had, on average, the highest proportion of infective fleas; hence such strains have a selective advantage and have become predominant under natural conditions in Britain. The changes that might occur if there is an increase in host resistance to myxomatosis are discussed.


Letter to the editor: Plasmid engineering: embargo or what?


Multiple skin testing of Kenyan schoolchildren with a series of new tuberculins. This study on Kenyan schoolchildren aims to elucidate the effect of contact with environmental mycobacteria on the development of specific delayed hypersensitivity. A series of 12 skin test reagents was employed; eleven of them were prepared from extracts of living mycobacteria and the last was the P.P.D. RT 23. Eight of the new tuberculins were prepared from mycobacteria recovered from the East African environment. A total of 8641 tests were carried out on 4320 children between the ages of 6 and 17 years in four townships. Two of these townships were in fertile agricultural areas and two were in the desert. Just over 80% of the children had received BCG immunization The results obtained showed that increasing age, geographical locality and BCG immunization all had a profound effect, and socioeconomic background had some effect, on the pattern of reactivity to the various reagents. The rationale behind the use of the series of new tuberculins and the results obtained with them are discussed in relation to the interacting effects of the factors complicating these results.


Observations on the epidemiology of ephemeral fever in Kenya. Ephemeral fever antibody was found in domestic cattle in Kenya across a wide range of ecological zones, from highland forests and grasslands to desert and semidesert thorn scrub. Antibody was found in several species of game animals, notably waterbuck and buffalo, where over 50% of the samples showed antibody to EF. Evidence was obtained to show that the virus had been cycling in these wild ruminant populations between epizootics in domestic cattle.


Contribution to the reconstruction of the lower lip after tumour resection combined with neck dissection. Methods of reconstruction of lip defects following tumour resection must also be assessed in their suitability, as to whether it is possible to combine the simultaneous total excision of the regional lymphatic drainage with the achievement of a functionally and aesthetically satifactory result. The current methods of reconstruction in use in the Hamburg Clinic are demonstrated from this point of view. By viualising the lymphatic drainage in tumours of the lower lip, it is shown that there is no method of reconstruction which realises the principle of en bloc resection of tumours. Supported by the results of postoperative investigation, it can, however, be shown that the percentage of recurrence in the area of lymphatic drainage can still be kept extremely low by observing various principles.


Curative treatment of malignant midline granuloma of the face. The symptomatology of the malignant centro-facial granuloma is described. A case and its treatment are demonstrated. Radiotherapy achieved complete healing. The possibilities of treatment are discussed and the author expresses the opinion that radiotherapy is the method of choice for treating centro-facial malignant granuloma.


New concept of morphogenesis of clefts in the lip, alveolus, and palate. The morphogenesis of clefts in the lip, alveolus, and palate is a process of both functional and formative adaptation of the affected mouth cavity to the disturbance which the cleft would represent in "pumping" the amniotic fluid. Only a normally developed portal venous system of the foetus, which is a continuation of the digestive canal through the liver, ensures efficient per-oral nutrition after birth. According to the findings known to date, the foetus feeds by "pumping" the amniotic fluid as early as the end of the third month of pregnancy. The amniotic fluid and nutritive substances contained in the fluid, which the foetus receives from the mother through the umbilical vein, are for the greatest part discharged through the foetus's skin. The morphogenesis of clefts proves the formative power of the tongue and its importance in the development of the mouth cavity as well as the ability of the normal growth response of the tissues around the cleft.


Clinical Experience in the Cryosurgery of Haemangioma. The author using cryoapplicator of his own modification presents cryosurgery as a successful surgical technique in cases of haemangiomas involving the face, lips, tongue and oral cavity. From 1968 to 1974 in the Stomatological Clinic of Lublin 56 patients were operated upon using this method. The results were very encouraging. Total regression of haemangiomas and regeneration of normal mucosa with no noticeable scar resulted. A method of cryosurgery especially suitable for very young patients or for those who are poor risks because of associated disease and advanced age is suggested.


Experiences on the sequela of maxillary sinusitis following closure of the causative oro-antral fistula. After describing the method of treating sinusitis in established oro-antral fistulae, which consists of irrigation of the maxillary sinus, antibiotic therapy and closure of the fistula, our experience gained on 75 cases checked postoperatively is presented. We found that a radical operation of the sinus, even later, was not necessary in most cases (present investigation of our clinical material showed 97.3 per cent). The inflammatorily a altered mucosa recovers after the elimination of the causative factor, which in this case is the closure of the oro-antral fistula. These findings thus correlate with those made by Obwegeser a and Tschamer (1957) and by Killey and Kay (1967).


Mid-face anthropometry on the cephalometric radiograph in cleft lip and palate cases. An attempt is made to analyse mid-face deformities objectively in operated cleft lip and palate patients with the help of cephalometric techniques. Mid-face growth of cleft patients after the age of 10 years is compared with growth parameters of non-cleft subjects. This comparison indicates that some of the angles in the nasal area (Subnasale angle, Alaria angle) do not undergo any change in size with increasing age. Others which are subject to change (Rhinion angle, Pronasale angle) show no difference in the extent of growth between cleft patients and normal subjects inspite of different conditions at the age of 10 years. The lateral growth of the nasal soft parts (bialar distance) is largely independent of the lateral growth of the bony structures.


Conservative treatment of cervico-facial suppurations. The author prefers conservative treatment of suppurations in the cervico-facial area. It consists of evacuation of pus by puncture and simultaneous instillation of antibiotics. The technique for superficial and deep infections is described. On the basis of 470 cases treated the method is considered very efficient.


Letters to the editor: Use and abuse of informed consent.


Editorial: Teaching physical diagnosis to dental students.


ASOS Committee on Advanced Education workshop for chiefs and faculty of oral sugery training programs.


Teaching of physical diagnosis to dental students and oral surgery residents. To provide background information related to teaching of physical diagnosis, a survey was sent to all dental schools and approved oral surgery residencies. Seventy-eight percent of the schools and 90% of the residencies responded. Analysis of the data indicated only half of the reporting schools taught physical diagnosis to predoctoral students in a specifically designated course. Comparison of the type and duration of experience with that offered to medical students showed a great disparity between the two groups. The programs in physical diagnosis provided to oral surgery residents compared much more favorably with those offered medical students and were superior in some aspects. However, the total experience was not comparable to that which a resident in a medical specialty would obtain. It may be concluded from these data that the weakest link in the educational experience of the oral surgeon related to physical diagnosis lies in the predoctoral program.


What constitutes appropriate training in physical diagnosis and medicine for oral surgeons?


Evaluation of competence of the oral surgeon in physical diagnosis.


Principles of treatment for temporomandibular joint ankylosis. An understanding of the growth and development of the temporomandibular joint (TMJ) is necessary for successful treatment of TMJ ankylosis. The concept of a growth center in the condyle is probably misleading; instead, the soft tissues of the orofacial region seem to provide the primary growth forces. As a result of this concept, methods of treatment should be reexamined.


Surgical correction of temporomandibular joint arthritis. Restoration of the contour of the articular eminence with a prosthesis has been successful when chronic sublaxation has resulted from flattening of the eminence. Use of a prosthesis is helpful in the treatment of patients with arthritic disease of the temporomandibular joint. A careful differential diagnosis is necessary to eliminate other possible causes of the patient's symptoms.


Eminectomy for the treatment of recurrent temporomandibular joint dislocation. Several techniques have been used to treat chronic dislocation of the mandible. Most of these techniques represent attempts at reducing the mobility of the TMJ. The eminectomy procedure is an attempt at restoring normal joint function without reducing mobility of the joint. We have presented two cases of chronic dislocation of the mandible that were treated successfully by removal of the articular tubercle and the lateral portion of the temporal bone. Although surgery of the TMJ area may be hazardous if approached without caution, we feel that the complications associated with this procedure are minimized if adequate care is taken in flap design and tissue dissection. On the basis of the excellent results of the eminectomy procedures reported in the literature and of our own experience with this procedure, we feel that this is the preferred treatment for chronic dislocation of the mandible.


Symptomatic osteoarthritis of the temporomandibular joint: report of a case. A case of osteoarthritis in the TMJ which manifested clinical symptoms, radiographic changes, and the classic microscopic alterations has been presented. Whether the condition was a primary or secondary form of the disease could not be unequivocally ascertained, as the symptoms preceded the injection of a sclerosing solution and a mandibular fracture, both of which could be significant contributing factors to a trauma-induced secondary osteoarthritic change. Nevertherless, a lack of symptoms in other joints would tend to exclude a generalized (primary) form of osteoarthropathy. In this regard, symptoms referable to the TMJ (to the exclusion of other joints) are more consistent with findings of secondary osteoarthritic change. Whether osteoarthritic changes were discernible by radiography in the TMJ before the traumatic episodes recorded in the history is unknown. Indeed, a developmental anatomic anomaly could not be ruled out. Regardless of whether the changes were the result of primary degenerative disease or chronic trauma, the symptoms were adequately resolved by surgical intervention.


Temporomandibular joint ankylosis secondary to Marie-Strümpell disease. Marie-Strümpell disease, or ankylosing spondylitis, is a severe arthritic disorder that may involve the TMJs. Bony alkylosis may result and cause lack of jaw mobility. Familiarity with this disease entity and other arthritic disorders is a necessity for the dentist and oral surgeons.


Bilateral enlargement of the mandibular coronoid processes in a patient with rheumatoid arthritis of the temporomandibular joints. A case of rheumatoid arthritis of the temporomandibular joint with enlargement of both coronoid processes has been presented. Limited excursions of the mandible were due mainly to the encroachment of the coronoid processes on the posterolateral surfaces of the maxilla. The condition was relieved by unilateral arthroplasty and bilateral coronoidectomies. The etiology of the enlarged coronoid processes is unknown. However, the condition does resemble that which occurs experimentally when condylectomy is performed and the ramus is shortened. In this case, shortening of the ramus could be attributed to condylar destruction by the arthritic condition.


Dynamic splints for rehabilitation after surgical treatment of ankylosis. Using strictly surgical techniques without rehabilitation often leads to a systemic pattern of relapse within approximately a year's time. With the technique proposed, we have obtained functional recuperation that has persisted for more than five years (Fig 4). We feel the splints are useful because they afford comfort to the patient, a shorter hospitalization period, and no risk of infection.


A correlation between microscopic numerical evaluation, clinical scoring and total collagen content in inflamed gingivae. The histopathological observation was carried out on 12 periodontally involved gingivae and the microscopic inflammatory index was utilized for a quantitative expression of the periodontal pathology. Namely, each of 40 to 50 sections obtained from one gingival biospy was microscopically examined concerning the changes in the epithelium of the periodontal pocket and the gingival lamina propria which were divided into several items tested. The total number of the indices for each item examined was defined as the microscopic inflammatory index in individual cases. This index showed a tendency to increase proportionally to the decrease of the amount of collagen per wet weight of gingiva adjacent to the gingival biopsy aforementioned. In evaluating periodontal diseases, this estimation appears to be more objective and reproducible compared with other various indices based on clinical observation.


A chlorhexidine-containing methacrylic gel as a periodontal dressing. The modification of a methacrylic gel for use as a periodontal dressing was attempted. The increased adhesion and rigidity of the resultant material appeared consistent with the clinical findings. Satisfactory retention of the dressing was found in 85% of those placed on a group of patients attending for periodontal surgery. The potential value of the methacrylic gel for carrying and releasing pharmacological agents useful in the management of lesions of the oral mucosa was assessed by incorporating chlorhexidine acetate into the dressing. In vitro and in vivo studies demonstrated effective release of the chlorhexidine from the dressing throughout the period of time a periodontal dressing is normally in situ. In conclusion the results suggested that the modified methacrylic gel fulfills the requirements of a periodontal dressing. Study to assess further the potential for this material to carry other pharmacological agents used in the topical treatment of lesions of the oral mucosa is indicated.


Antibacterial properties of periodontal dressings. The relationship between the build-up of bacterial plaque at the dento-gingival junction and the development of gingivitis is well established. The susceptibility of patients requiring periodontal surgery to the pathogenic potential of plaque would seem to necessitate the protection of the surgically treated area by a periodontal dressing until adequate plaque control by the patient is possible. In the light of clinical experience, an investigation was undertaken into the antibacterial properties of certain proprietary periodontal dressings and a zinc oxide/eugenol material. None of these materials showed any marked degree of antibacterial activity. One of these materials, Coe-Pak, had been used alone or combined with Cross Pack for all the patients in the clinical survey with very satisfactory results, and it is concluded that this material is successful because of its physical properties and not its antibacterial ones. Careful attention to asepsis, gentle and controlled tissue handling, correct technique, and thorough removal of plaque and calculus are the prerequisites for successful periodontal surgery. The protection of the surgical wound by a dressing of adequate physical properties aids in ensuring uneventful healing. The use of potent antibacterial agents in the dressing is not necessary; a physical barrier to salivary/bacterial contamination and food impaction may be the most important factor.


The dento-gingival junction. An interpretation of the literature.


Clinical study of iodine as a chemotherapeutic agent for the control of dental plaque and gingivitis in man. The present investigation was conducted to study the effect of the local use of iodine solution as a chemotherapeutic agent on the degree of dental plaque formation and ongingival status in the presence and absence of mechanical oral hygiene. Thirty-six male dental students, 20 freshmen and 16 sophomores, at Case Western Reserve University, participated in the study. All subjects received a prophylaxis and oral hygiene instruction to reduce their plaque and gingival scoeres before the start of the experiment. The 20 freshmen dental students were selected for the test of iodine used in a form of mouthwash. The subjects were randomly divided into two groups. One group received a 0.02% iodine mouthwash, the other a placebo solution of distilled water. Each student was randomly assigned to brush and floss the right or left side of his dentition once daily. The students rinsed with 7.5 ml. of the assigned solution twice daily. The 16 sophomore dental students were selected for the test of iodine applied topically on the tooth surfaces. The subjects were assigned to a randomized block design in which each quadrant received one of the following treatments daily: topical application of iodine solution (2.0% I2 and 2.4% NaI) with brushing and flossing, brushing and flossing only, topical application of iodine solution only, and topical application of distilled water only...


Odontogenic fibromyxoma arising from the periodontal ligament. A case is reported of an intraosseous odontogenic fibromyxoma which presented as an epulis and appeared to arise from the periodontal ligament of an upper lateral incisor. True neoplasms rarely present in this fashion, and the literature reveals no report of an intraosseous myxomatous neoplasm exhibiting such clinical features. Evidence supporting the periodontal ligament origin of the lesion is presented and discussed.


Dental prophylaxis procedures in control of periodontal disease in Lucknow (rural) India. Frequent professional scaling and regular tooth brushing are the main public health measures available for preventing and controlling periodontal disease but their frequency and efficacy are still incompletely understood. This investigation was carried out on 1,416 rural children and 189 factory workers in Lucknow area in the age groups 14 +/- 1, 17 +/- 1 and 28 +/- 2 years of age to evaluate the optimum requirement of these measures to the extent they will be economical and usable in the public health programs. The prevalence of gingivitis and periodontal disease in Lucknow children and adult samples was found to vary between 93 to 100%. Periodontal disease (including gingivitis and loss of attachment) and calculus accumulation showed considerable reduction (P less than 0.01) with any type of treatment. Scaling alone will not reduce the plaque formation for which regular tooth brushing is essential. Yearly and half-yearly scaling along with tooth brushing instructions will considerably improve and maintain the oral hygiene thereby reducing the prevalence and severity of periodontal disease, plaque, and calculus accumulations. However, more intensive measures (quarterly prophylaxis) will further improve the periodontal health and reduce calculus accumulation. The apical migration of the epithelial attachment can practically be stopped by rendering scaling half yearly, without any instructions in oral hygiene and elimination of dental plaque.


Editorial operation--maintaining the high standards set by Dr. Carl O. Boucher.


A new concept of periodontal diseases.

A new concept of periodontal diseases. Both the inflammatory and noninflammatory types of periodontal diseases begin with an aseptic, traumatic destruction of alveolar bone, caused by traumatizing parafunctions and followed by changes in the gingiva. The latter may or may not have a superimposed infectious inflammatory process. A new concept to fit these facts is proposed: periodontal diseases are autodestructive processes in the masticatory system, with or without superimposed septic inflammation. To confirm the theory of autodestruction, direct evidence as well as indirect but conclusive evidence is given for the existence of traumatizing forces in the masticatory system, for traumatic destruction of alveolar bone, for changes in the gingiva following destruction of alveolar bone, and for the parafunctions by all persons afflicted by periodontal disease. It is concluded that traumatizing parafunctions are the main factor in the etiology of periodontal diseases and that in therapy recurrences are inevitable unless parafunctions have been eliminated.


A variation in complete mandibular impression form related to an anomaly of the mylohyoid muscle. 1. Mylohyoid eminentiae form on the lingual flange of a denture impression when a gap exists in the mylohyoid muscle. The gap, when void of resistant structures, allows the overlying mucous membrane to sag into the aperture under pressure from impression material. 2. The eminentiae may be considered clinically unimportant, because they can be altered if necessary without affecting the serviceability of the denture.


Planning for individualized prosthetic treatment.


Use of the remount jig as an aid in relining upper dentures. A remount jig record is used to reposition the teeth of an upper denture reline in their original position. A face-bow record is used to position the upper edentulous cast in the correct relation to cranial planes. The impression may be developed as is done in any other impression procedure, and the repositioning can be accomplished in the laboratory with reasonable assurance that the upper denture is positioned occlusally as it was when the denture was constructed originally. This procedure relieves the dentist of the monumental task of making a reline impression and adjusting the position of the denture in one three-minute operation.


Modification of stresses in alveolar bone induced by a tilted molar. Stresses induced in the supporting bone by a tilted molar tooth under load have been investigated by both the photoelastic and the finite element model systems. The following conclusions were reached. 1. Altering the angle of the load applied to the unsupported molar from 0 (axial) to 30 degrees resulted in a fourfold increase in compressive stress in the supporting bone mesial to the tooth. 2. Increasing the load from 30 to 90 pounds while maintaining a 30 degree angle of application resulted in a linear increase in the shear stress on the supporting bone mesial to the tooth. 3. Following the placement of a fixed partial denture, the induced stress at a point on the mesial aspect of the molar tooth, subjected to a 60 pound load at 30 degrees to the long axis, was reduced from 241 to 43 p.s.i. 4. The introduction of a fixed partial denture resulted in a decrease in the compressive stress in the bone adjacent to the apex of the mesial root of the molar from 481 to 174 p.s.i. 5. A distributed 120 pound load applied over the length of the fixed partial denture compared against individual tooth loadings of 60 pounds revealed that placement of the fixed partial denture favored the tilted molar at the expense of the premolar.


The immediate palatal plate.

The immediate palatal plate. The immediate palatal plate is therapeutically beneficial for relief of temporomandibular joint pain, for reduction of occlusal trauma with and without selective grinding, for orthodontic tooth movement as a disarticulating device, and for relief of pericementitis subsequent to periodontal surgery. The immediate palatal plate is durable and well tolerated by patients and has established itself to be more than just an interim appliance.


Compressive facial splints.

Compressive facial splints. A method of constructing long-term compressive splints for the regions of the head and neck using available materials has been described. These splints have been useful where continuous pressure is needed to promote healing or enhance treatment over long periods of time.


The bony residual ridge in man.

The bony residual ridge in man. The bone which fills in the socket after tooth extractions was investigated in 120 dry skull specimens and 100 radiographs in which one or more teeth had been missing for at least three months. The bony content of the socket was of the trabecular type. This trabecular bone was well differentiated from the adjacent cortical bony plates. In buccolingual sections, the residual crest was formed by dense trabecular bone, clearly differentiated from the cortical plates as well as from the less dense trabecular bone that was deeper within the former sockets. From the occlusal aspect, the crest of the edentulous surface had shifted lingually when compared to the original position of the teeth before extractions. From the lateral aspect, the residual ridge formed a concavity or went straight between the alveolar crests of the adjacent remaining teeth. When several teeth were missing, the concavity was more pronounced than when a single tooth was missing.


Chronic myofascial pain-dysfunction syndrome with chest pain. A patient with a myofascial pain-dysfunction (MPD) syndrome with pain radiating into the chest has been described. A direct relationship between a dental malocclusion and the chest pain was confirmed by tests. The patient was treated for MPD syndrome related to the malocclusion, and the chest pain symptoms were relieved. This report demonstrates the need for the dentist to consider not only the muscles of mastication in the management of problems of the neuromuscular apparatus but also the delicate balance which exists between the masticatory apparatus and the postural muscles of the head and neck.


A case of osteogenic sarcoma of maxillary antrum cure by radiation therapy.


Restoration of immunocompetency by lymphocyte transfusion. A female patient with metastatic osteosarcoma was given a lymphocyte transfusion from her brother, cured of the same histologic type of tumor ten years earlier. Prior to the transfusion the patient was anergic. Following lymphocyte transfer cutaneous reactivity to DNCB was restored. Skin reactivity to mumps and varidase antigens was specifically transferred. Whole lymphocyte transfer is a feasible method for restoring immune competence in the anergic cancer patient.